The Etiological Relationship Between Anxiety Sensitivity, Sexual Distress, and Female Sexual Dysfunction is Partly Genetically Moderated

Abstract

Presence of sexual distress is diagnostic requirement for female sexual dysfunction (FSD). However, previous correlational research indicates that sexual distress in women may be related to general anxiety per se rather than being an outcome of FSD. In this exploratory study, we test, for the first time, whether the correlation between anxiety sensitivity, sexual distress, and FSD can be explained by shared genetic and nongenetic factors using multivariate twin modeling. Questionnaire data were available on a representative final sample of 930 Caucasian British female twin individuals (119 monozygotic twin pairs, 67 dizygotic twin pairs, and 558 single twins; aged 18-85 years). Validated scales assessed anxiety sensitivity, sexual distress, and FSD and included the Female Sexual Function Index, the Female Sexual Distress Scale, and the Anxiety Sensitivity Index. Questionnaire responses were subject to trivariate heritability analyses to assess common genetic and environmental influences underlying specific trait variance and the covariance between the phenotypes. Heritability for FSD was 28%, 48% for anxiety sensitivity, and 44% for sexual distress. The phenotypic associations among anxiety sensitivity, sexual distress, and FSD were all significant. Trivariate analysis indicated that additive genetic factors accounted for approximately 75% of the covariance between anxiety sensitivity and FSD 35% of the covariance between anxiety sensitivity and sexual distress, and 11% between sexual distress and FSD. The association between anxiety sensitivity and FSD has a common genetic component. There is a weaker genetic link between anxiety sensitivity and sexual distress and between sexual distress and FSD. These data, while silent on direction of causality, suggest a role for pleiotropic genetic factors influencing anxiety sensitivity and FSD. They also highlight a need to refine the inclusion of distress in classifications of disorders of female sexual functioning.